Provider Demographics
NPI:1699963413
Name:GALLAGHER FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:GALLAGHER FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-435-5336
Mailing Address - Street 1:2970 CORPORATE CT STE 4
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-3158
Mailing Address - Country:US
Mailing Address - Phone:610-435-5336
Mailing Address - Fax:610-435-5172
Practice Address - Street 1:2970 CORPORATE CT STE 4
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-3158
Practice Address - Country:US
Practice Address - Phone:610-435-5336
Practice Address - Fax:610-435-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111916Medicare PIN